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Houston Health Department seeks changes to private ambulance rules, proposes reinspection fees and stroke‑unit authorization
Summary
Health Department EMS staff proposed updates to Chapter 4 to adopt state equipment lists, allow mobile stroke units to operate under city agreements, authorize out‑of‑state contracted drivers to obtain city permits, and add reinspection fees. Volunteer EMS groups requested fee exemptions and authority to operate under city agreements.
City of Houston Health Department staff told the Quality of Life Committee on Monday they will propose a set of changes to Chapter 4 of the City Code governing private ambulance services, including a shift to Texas Department of State Health Services equipment lists, a reinspection fee, and a new authorization path for specialized emergency units such as mobile stroke units.
Kevin Hart, supervisor of the Health Department’s Emergency Medical Services (EMS) program, said the program’s goal is to "improve the patient care outcome by ensuring the safety, reliability, and readiness of emergency medical services." Hart described routine annual inspections, field spot checks at hospitals and nursing homes, and requirements for permits for agencies, vehicles and drivers that operate private ambulances in Houston.
Hart said private operators perform non‑emergency transfers—moving patients between hospitals, nursing homes, dialysis centers and rehab facilities—while the Houston Fire Department provides 911 emergency responses. Hart told the committee the EMS program inspects applicant services and each vehicle, verifies driver records (three‑year certified driving record, limited moving violations) and enforces equipment and insurance requirements under Chapter 4.
Proposed ordinance changes Hart described include:
- Replacing the American College of Surgeons equipment standard with the Texas Department of State Health Services list and an annually reviewed Houston list developed with an EMS physician and the Houston Fire Department. Hart said the national list omits items local clinicians consider essential (he cited naloxone/Narcan as an example). - Adding a reinspection fee to discourage repeated failed inspections and reduce staff time spent on multiple return visits to noncompliant vehicles; current medallion/decals generate application fees but there is no reinspection charge. - Creating a mechanism to authorize specialized vehicles—such as mobile stroke units that carry atypical equipment—to operate in an emergency capacity when dispatched by the Houston Fire Department under a city agreement. - Allowing the city ambulance‑driver permit to be issued to contractors who hold an equivalent out‑of‑state Class C driver’s license so staffing‑shortage contractors can be permitted to drive in Houston without requiring a Texas driver’s license during short contracts. - Updating or removing obsolete statutory references in Chapter 4 and aligning minimum insurance levels with state requirements.
Hart said the city inspects roughly 750 private ambulances that operated last year and performs comprehensive annual inspections on each vehicle the Health Department permits; by contrast, he said, the Houston Fire Department maintains about 20 EMS vehicles. He told committee members repeated reinspections and inspections of poorly prepared vehicles pull investigators from other field duties and harm patient care readiness.
During public comment, David Fishman of Hatzella of Houston, a volunteer nonprofit emergency medical service, asked the city to grant volunteer, nonprofit EMS organizations the same fee exemptions the state provides, specifically ambulance‑licensing, agency licensing and ambulance‑driver permit fees, and to update Section 4‑9(a) to allow volunteer nonprofit agencies to provide emergency ambulance services under a formal agreement with the city. Fishman said those changes would free resources for lifesaving response.
City Ambulance Service and other private operators told the committee they support the proposed changes; industry speakers said a reinspection fee and clearer equipment list would improve consistency. Committee members asked about fee structure and whether reinspection revenues would be reserved for EMS program work; staff said existing EMS fees generally go to a special fund supporting program activities and that the precise reinspection amount and fee structure would be set later in the city fee schedule.
No ordinance was adopted at the meeting; staff will return with proposed language and fee figures for council consideration. Hart said his office will continue to coordinate with the Houston Fire Department and the city’s medical director to finalize equipment lists and the proposed rulemaking authority that would allow the director to issue temporary or emergency rules as state or operational conditions change.
